Mymensingh medical journal : MMJ
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This prospective study was conducted to compare the outcome of endoscopic sinus surgery (ESS) using SNOT-20 score chart (subjective) and Lund & Kennedy scoring chart (objective) and carried out in the Department of Otolaryngology & Head-Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Dhaka Medical College Hospital (DMCH) & Shaheed Suhrawardy Medical College Hospital (ShSMCH) from July 2010 to March 2012. Total 73 admitted cases were selected purposively for ESS, male 53(72.60%) and female 20(27.40%). Among the study participants 10(13.7%) had chronic rhinosinusitis with bilateral polyposis and 26(35.62%) had chronic rhinosinusitis with unilateral polyposis and 12(16.44%) had bilateral chronic rhinosinusitis without polyposis and 25(34.25%) had unilateral chronic rhinosinusitis without polyposis. ⋯ Symptomatic relief and quality of life improvement after ESS was compared by improvement in post operative scores of SNOT-20 & Lund-Kennedy score of endoscopic assessment. Post operative lower values were considered to be better improvement status. The results of the study suggests that ESS performed in Chronic Rhinosinusitis without Polyposis cases, relief of symptoms and quality of life improved was better than Chronic Rhinosinusitis with Polyposis cases postoperatively as compared by SNOT-20 and Lund & Kennedy score of endoscopic assessment.
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Large Intracerebral hematoma (ICH), compounded by perihematomal edema can produce severe elevations of intracranial pressure (ICP). Decompressive craniectomy (DC) beneficially addresses mass effect. Therefore this study is aimed to prove that decompressive craniectomy with durotomy has better outcome in patients with spontaneous supratentorial ICH than conservatively treated patients. ⋯ In logistic regression analysis, conservative group was 3.643 times more prone to develop poor outcome than surgical group which was statistically significant (95% CI, 1.040-13.047; p value <0.05) and volume of hematoma [OR (95% CI), 1.131(1.059-1.207); p value <0.001)] was the most important predictor of outcome. This study indicates that decompressive craniectomy with preservation of brain integrity in patients with spontaneous supratentorial ICH is feasible and safe. It can be a useful alternative surgical procedure in the treatment of spontaneous supratentorial ICH.